Latest news with #VHA
Medscape
20 hours ago
- Health
- Medscape
Gout Patients Face Elevated Risk for Chronic Opioid Exposure
TOPLINE: Veterans with gout were 30% more likely to be prescribed chronic opioid therapy than those without gout, with factors such as female sex, underweight BMI, current smoking status, and a higher burden of comorbidities increasing this likelihood. METHODOLOGY: Researchers conducted a matched cohort study to determine whether patients with gout were more likely than matched control individuals without gout to have a risk for chronic prescription opioid exposure. They also sought to identify the clinical factors associated with chronic opioid exposure. Data related to 419,967 patients with gout and 3,609,382 matched control individuals from the Veterans Health Administration (VHA) records (January 2000-July 2020) were included (overall mean age, 67.6 years; 99% men). Chronic opioid exposure was defined as at least 90 days' cumulative supply from two or more pharmacy dispensing episodes occurring in a 6-month window without a gap of 32 or more days. Patients were followed up for a mean duration of 4.52 years. Medications such as acetaminophen/hydrocodone, buprenorphine, codeine, fentanyl, hydromorphone, morphine, methadone, oxycodone, and tramadol were considered as opioids. TAKEAWAY: Patients with gout were 30% more likely than control individuals to receive prescriptions for chronic opioid use (adjusted hazard ratio [aHR], 1.30; 95% CI, 1.28-1.32). Among patients with gout, factors associated with an increased likelihood of chronic opioid exposure included female sex (aHR, 1.29; 95% CI, 1.14-1.46), underweight BMI (aHR, 1.32; 95% CI, 1.13-1.54), and current smoking status (aHR, 1.62; 95% CI, 1.55-1.68). Additional risk factors included requiring rheumatology consultation (aHR, 1.60; 95% CI, 1.54-1.66), receiving urate-lowering therapy (aHR, 1.30; 95% CI, 1.27-1.34), and having a higher Rheumatic Disease Comorbidity Index score (aHR, 1.26; 95% CI, 1.25-1.27). Overweight BMI, the presence of chronic kidney disease, and evidence of adequate serum urate control were factors associated with a lower risk for chronic opioid exposure. IN PRACTICE: 'In conclusion, we found in the VHA that patients with gout were more likely than those without gout to be prescribed opioids leading to chronic use after accounting for other possible determinants of receipt,' the study authors wrote. 'This study also identified several factors that appear to identify patients with gout at highest risk of receipt, factors that might ultimately be used in targeted efforts to reduce long-term prescription opioid use in this population,' they added. SOURCE: The study was led by Lindsay N. Helget, MD, Veterans Affairs Nebraska-Western Iowa Health Care System in Omaha, Nebraska, and was published online on August 4, 2025, in Arthritis Care and Research. LIMITATIONS: Administrative data restrictions prevented reliable identification of both the indication and specialty origin for index prescriptions. The predominantly male population may limit the generalizability of the findings. Reliance on algorithms leveraging administrative data could have led to misclassification of gout status and chronic opioid exposure. DISCLOSURES: This study was supported by a Scientist Development Award from the Department of Internal Medicine at the University of Nebraska Medical Center. Some authors received support or grants from Veterans Affairs Clinical Science Research & Development, the Rheumatology Research Foundation, the National Institutes of Health, Veterans Affairs, the US Department of Defense. Some authors reported receiving grants or contracts and/or consulting fees from various sources. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Newsweek
3 days ago
- Health
- Newsweek
VA Report Finds 'Severe' Staffing Shortages
Based on facts, either observed and verified firsthand by the reporter, or reported and verified from knowledgeable sources. Newsweek AI is in beta. Translations may contain inaccuracies—please refer to the original content. The Department of Veterans Affairs is facing "severe" staffing shortages at its hospitals, with many struggling to fill jobs for doctors, nurses and psychologists, according to a new report from the agency's independent watchdog. The report from the VA's Office of Inspector General, released on Tuesday, said Veterans Health Administration (VHA) facilities reported 4,434 "severe occupational staffing shortages" in the 2025 fiscal year — a 50 percent increase from the 2024 fiscal year. The report is based on surveys taken at 139 VHA facilities from late March to early April. A Department of Veterans Affairs clinic in Daytona Beach, Florida, in July. A Department of Veterans Affairs clinic in Daytona Beach, Florida, in July. Phelan M. Ebenhack/AP Photo Why It Matters The VHA is the largest integrated healthcare system in the United States, providing care to millions of veterans each year. The surveys that the report was based on were taken after it was reported that the VA planned to cut 80,000 jobs — out of roughly 484,000 — through the so-called Department of Government Efficiency. The VA later reduced that figure to nearly 30,000 jobs cuts by the end of the fiscal year. Veteran Affairs Secretary Doug Collins said that staff cuts would not affect care, but the report's findings raise concerns about a lack of essential healthcare staff in VA facilities. What To Know The report found that nearly all of the facilities (94 percent) surveyed reported a shortage of medical officer occupations including doctors, while 79 percent reported shortages of nurses. But the report noted that severe shortages for medical officers and nurses have been identified every year since 2014. The report also said that at least 20 percent of facilities identified severe staffing shortages for 43 occupations overall, the highest number since 2018. Psychology was the "most frequently reported clinical occupational staffing shortage," with 57 percent of facilities reporting a lack of staff. The top reported shortage for non-clinical positions was for police officers, with 58 percent of facilities reporting it. Pete Kasperowicz, the VA's press secretary, said in a statement that the report was "not a reliable indicator of staffing shortages." But Representative Mark Takano, the ranking Democrat on the House Committee on Veterans' Affairs, said the report confirms fears that the VA is facing staffing shortages leading to "decreased access and choice for veterans." What People Are Saying Kasperowicz, the VA's press secretary, said in a statement: "The report simply lists occupations facilities feel are difficult for which to recruit and retain, so the results are completely subjective, not standardized and unreliable." Takano said that the report "confirms our fears: VA and veterans are worse off under Doug Collins's leadership. Instead of making VA an employer of choice, Secretary Collins continues to vilify the VA workforce and strip them of their rights. Now, VA is facing critical staffing shortages across the country, leading to decreased access and choice for veterans. Veterans deserve and have earned better." What Happens Next Further staffing shortages are expected as the department continues to reduce staff through hiring freezes, deferred resignations, retirements and attrition by the end of the fiscal year. Meanwhile, ProPublica reported last week that veterans hospitals are struggling to replace the doctors and nurses who have left the healthcare system this year. Records show that almost 40 percent of doctors offered jobs from January through March turned them down.
CBS News
5 days ago
- Health
- CBS News
Staffing shortages at VA health systems are on the rise, watchdog finds
Health care staffing shortages at the Department of Veterans Affairs are on the rise, according to a new watchdog report. In the report, out Tuesday, the VA's Office of Inspector General, or OIG, found Veterans Health Administration facilities reported 4,434 staffing shortages this fiscal year, which is a 50% increase from fiscal year 2024. Almost all — 94% — of facilities reported severe shortages for medical officers, while 79% of facilities reported severe shortages for nurses, according to the report. The report's data comes from questionnaires sent to 139 VHA facilities, comparing 2025 responses to 2018-2024 responses. The 2025 questionnaires were distributed via email on March 26 with a required completion date of April 9. Data on staffing shortages at VA facilities has been collected annually for over a decade, and the report notes that this is the eighth report to identify severe occupational staffing shortages at the facility level. The report notes that the OIG did not independently verify VHA data for accuracy or completeness. It also says that due to the timing of the questionnaire, any impact on staffing from OPM's Deferred Resignation Program and VA's workforce reshaping efforts — which are expected to lead to further staffing shortages — were not fully reflected. In response to the report, Pete Kasperowicz, press secretary for the U.S. Department of Veterans Affairs, said it is "not based on actual VA health care facility vacancies and therefore is not a reliable indicator of staffing shortages." "The report simply lists occupations facilities feel are difficult for which to recruit and retain, so the results are completely subjective, not standardized and unreliable," he said in an emailed statement to CBS News on Wednesday. "VA's department-wide vacancy rates for doctors and nurses are 14% and 10%, respectively. These are lower than most other health care systems, in line with normal VA historical averages and much lower than the respective 19% and 20% physician and nurse vacancy rates VA saw at times during the Biden Administration." CBS News has reached out to the OIG's office seeking a response to Kasperowicz's statement. Others criticized the Trump administration after the findings. Sen. Mark Warner, a Virginia Democrat, said, "Under this administration, we've seen policy after policy that makes it harder for public servants to do their jobs and ultimately harder for veterans to get the care they've earned." "We also know from recent jobs reports that applications to work at the VA are plummeting. How do skyrocketing staffing shortages and declining applicant pools make it more 'efficient' for veterans to access the care and services they deserve? The answer is: they don't," Warner said in a statement. "If the administration is serious about honoring our veterans, it needs to stop undermining the VA workforce and start recruiting and retaining the skilled professionals who care for our heroes." Among the VHA facilities surveyed this year, at least 20% reported severe staffing shortages for more than 40 occupations — marking the highest number of job shortages reported since 2018, according to the report. Severe staffing shortages were also reported for psychologists at 57% of VHA facilities. For non-clinical positions, the highest reported shortage was for police officers, which about 58% of facilities reported.
Newsweek
09-06-2025
- Health
- Newsweek
Which US States Have the Highest Risk of Dementia?
Based on facts, either observed and verified firsthand by the reporter, or reported and verified from knowledgeable sources. Newsweek AI is in beta. Translations may contain inaccuracies—please refer to the original content. Your risk of developing dementia may be more closely tied to your ZIP code than you think, according to a large-scale study of U.S. military veterans aged 65 and older. Analyzing health data from over 1.2 million veterans who received care through the Veterans Health Administration (VHA) between 1999 and 2021, researchers found that where someone lives can significantly influence their chances of developing dementia—even after accounting for age, race, heart disease, diabetes, and whether they lived in rural or urban areas. The study revealed stark regional differences. Veterans living in the Southeast faced the highest risk, with dementia rates 25 percent higher than those living in the Mid-Atlantic, the region with the lowest rates. Other high-risk areas included the Northwest and Rocky Mountains, where dementia risk was 23 percent higher than in the Mid-Atlantic. The South, Southwest and South Atlantic also showed elevated rates. The researchers measured how many new cases of dementia were diagnosed each year per 1,000 people. In the Southeast, that number was 14 cases per 1,000 person-years, while in the Mid-Atlantic it dropped to just 11.2. Even after adjusting for factors like demographics, rurality and cardiovascular conditions, the regional patterns remained consistent. "The study underscores the need to understand regional differences in dementia and the importance of region-specific prevention and intervention efforts," said senior author Dr. Kristine Yaffe, also of the San Francisco VA Health Care System, in a statement. What Might Be Driving the Regional Differences? Researchers explored why dementia rates varied so widely across regions, and several key factors may help explain the gap. Although health, age, and environment clearly play a role, the data showed that geographic location remained a strong predictor even after accounting for those variables, suggesting there's more going on beneath the surface. Potential Factors Influencing Dementia Risk: Education: Lower educational attainment was more common in regions with higher dementia rates. Health Conditions: Chronic illnesses such as stroke, high blood pressure, diabetes and obesity were more prevalent in higher-risk areas like the Southeast. Lifestyle and Environment: Smoking and other regional lifestyle patterns may contribute. Access and Quality of Health Care: While the VHA generally offers more equal care across regions, differences in resources and specialty care at individual VA centers may affect how—and whether—dementia is diagnosed. Diagnosis Practices: Studies using Medicare data suggest that how often and how well dementia is diagnosed can vary, not just because of patient health but also due to how local health systems operate. Hidden Variables: Some important influences—such as quality of early-life education or early signs of cognitive decline not captured in health records—may not show up in administrative data but could still drive long-term risk. A stock image of a doctor visiting a senior man to check his health. A stock image of a doctor visiting a senior man to check his health. Photodjo/iStock / Getty Images Plus All-in-all, the study makes one thing clear: location matters. While individual lifestyle choices and genetics remain important, where you live could shape your brain health more than previously understood. These findings underscore the need for more localized research and targeted interventions, especially in regions facing higher dementia burdens. Understanding why dementia hits harder in some areas than others is essential—not only for treating the disease but also for preventing it in the first place. Do you have a tip on a health story that Newsweek should be covering? Do you have a question about dementia? Let us know via science@ Reference Dintica, C. S., Bahorik, A. L., Xia, F., Boscardin, J., & Yaffe, K. (2025). Regional differences in dementia incidence among US veterans. JAMA Neurology.
Time of India
26-05-2025
- Politics
- Time of India
SC cites ‘one-state, one-unit' rule, allows VHA to withdraw plea for HI membership
Nagpur: Vidarbha Hockey Association's (VHA) last ditch effort to get recognized as an associate-member of the national body 'Hockey India' was on Monday rejected by the Supreme Court . While refusing to entertain a VHA petition, the partial working day (PWD) bench of justices Surya Kant and Dipankar Datta verbally said, "Hockey is an Olympic sport and under the Indian Olympic Association (IOA) regulations, there can be only one association from one state. " Hockey Maharashtra is one of the 28 permanent members of Hockey India, which also has a total of 32 associate and 55 academy members. The VHA was an affiliated unit of HI in 2013, but the membership was taken away in January 2020. VHA challenged HI's decision in the Nagpur bench of Bombay high court. As legal proceedings were ongoing, HI retained VHA as an associate member till 2024. With the HC upholding HI decision, VHA's membership with the HI was considered withdrawn effective from July 1, 2020. In the Supreme Court, VHA prayed that HI continue it as an associate-member. When justice Kant examined the matter further, VHA's counsel informed that the association was in fact an associate-member of HI for six years from 2013. In 2020 that membership was taken away citing one-state, one-unit rule. The counsel also claimed that Delhi had over 20 associate-members in HI. Akshay Mann, VHA counsel, also cited the rules applied to cricket, where Maharashtra has three associations — Vidarbha Cricket Association, Maharashtra Cricket Association, and Mumbai Cricket Association — affiliated to the national body, Board for Control of Cricket in India (BCCI). He questioned the revocation of VHA's associate membership of HI. F rom the material placed on record, justice Datta noted that the petitioner was referring to the BCCI and Kabaddi Federation, which are not Olympic sports. According to the IOA regulations, the judge upheld the HI order in question, de-registering not only VHA but also Mumbai Hockey Association, as there can be only one association in Maharashtra. The judge orally grilled the VHA counsel as to what was the urgency to get the matter listed in partial court working days. "June 2024 order... you are filing SLP in May 2025... you are getting it listed in vacation... please tell us what is the urgency?" Before justice Kant dictated the order, justice Datta pointed to a specific page in the records, questioning if the petitioner had countered the aspect by filing an affidavit before the high court. When VHA counsel replied in negative, the judge said, "Then, that's the end of the matter... you should have explained before the high court, not before the Supreme Court for the first time." After hearing brief arguments, the SC bench allowed the petitioner to withdraw the case. Finally, the case was dismissed as withdrawn. Speaking to TOI VHA counsel Mann said, "This fight will continue. Clause 3.10 of the sports code says that there can be many types of membership without voting rights. There are still some valid and unresolved points which can be covered. We will reveal our strategy after discussions with VHA."
